Underinvestment in Primary Prevention
Lack of ringfenced government funding for primary prevention initiatives, leading to reactive rather than proactive approaches.
87 items
6 sources
1 inquiry
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
Committee recommendation
80match
#5 - Define government health prevention spending and increase flexible funding for local systems.
Given the constraints on public spending, it is highly likely that re- focusing attention from sickness to prevention cannot be achieved without re-allocating existing NHS funds in the same direction. Senior ICB leaders report a continued lack of progress with the government’s long-standing aim to move towards preventing ill health rather than 5 treating it. Furthermore, the public...
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terms: prevention
Committee recommendation
78match
#20 - Progress on health prevention hindered by acute care focus and reduced public health grants.
Senior ICB leaders reported to the National Audit Office a continued lack of progress with the government’s long-standing aim to move towards preventing ill health rather than treating it. One of the most important reasons cited by ICBs has been the focus on other pressing national priorities, particularly elective care backlogs and acute services, which has meant they...
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terms: prevention
Committee recommendation
66match
#22 - Inadequate definition and tracking of prevention spending impedes accurate assessment of policy progress.
Currently, NHSE does not even track spend and activity on prevention by ICBs at local levels, due to unavailability of data and the lack of consistency about what counts as prevention spending. While DHSC funds some prevention activities that sit outside the NHS, primarily through its Office for Health Improvement and Disparities (OHID), it similarly lacks a precise...
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terms: prevention
Committee recommendation
66match
#21 - DHSC believes prevention requires cultural and legislative change, not solely additional resource allocation.
DHSC told us it did not view providing more resources, or redirecting them from elsewhere, as a substantive part of the solution to the lack of progress with prevention. Instead, it considers that a shift towards prevention might be achieved through longer-term changes in culture, public attitudes and the legislative environment.36 There is a role for GPs to...
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terms: prevention
Committee recommendation
62match
#13 - Commission community pharmacies to provide HIV-prevention PrEP and all routine adult and child immunisations.
In the shorter term, and in light of the large body of evidence and long-running calls for these services to be offered in community pharmacy settings, we recommend that NHS England commissions community pharmacies to provide the HIV-prevention medication PrEP and all routine and seasonal immunisations for adults and children.
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terms: prevention
Committee recommendation
61match
#12 - Government commits to preventative oral healthcare measures including supervised toothbrushing and water fluoridation
The new government’s commitment to contract reform includes reference to a focus on prevention,27 and also to a programme of supervised toothbrushing for three, four, and five–year olds “most in need”.28 Tooth decay is a leading cause of hospital admissions for children in this country,29 and as DHSC told us in the session, prevention is preferable to needing...
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terms: prevention
Committee recommendation
60match
#8 - Thirty-Fifth Report - Introducing Integrated Care Systems
We are also concerned about the lack of progress on preventing ill-health rather than simply treating it.17 There also do not appear to be effective joint working arrangements between different government departments to tackle the causes of ill-health.18 The Department began a consultation in July 2019, Advancing our health: prevention in the 2020s, seeking views on proposals to...
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terms: prevention
Committee recommendation
57match
#24 - Overall NHS productivity remains low despite increased elective activity and community investments.
Despite carrying out 15% more elective activity than before the pandemic, the NHS is less productive overall once the activities of mental health trusts, community trusts and GPs are considered.42 NHSE told us that, while government has had a long-term aim to shift more care and services into local communities, funding increases for these services had often been...
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Committee recommendation
57match
#13 - DHSC acknowledges long-term healthcare shifts but prioritises immediate acute service pressures.
DHSC and NHSE told us that they were fully supportive of the new government’s aims to shift healthcare spending from treatment towards prevention, from hospitals to the community, and from analogue to digital. However, DHSC contended that these shifts would be hard to do and should take place only over the long term and not at the expense...
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terms: prevention
Committee recommendation
57match
#14 - Spending shifts from preventative to late intervention services, increasing later costs and worsening outcomes.
MHCLG recognises the importance of investing in prevention but also the challenge of funding it when finances are constrained.34 Preventative services help stop, delay or reduce the need for statutory services and can help to deliver better outcomes.35 Over the period 2015–16 to 2023–24, local authorities have spent more on some later intervention services and less on 26...
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terms: prevention
Committee recommendation
57match
#72 - Prioritise strategic funding deployment for early intervention in SEND to improve outcomes.
Funding must be strategically deployed to deliver the best outcomes for children and young people with SEND. This should include prioritised investment in early intervention. Timely and targeted support is essential 170 and can prevent some needs such as speech and language and SEMH needs from escalating, reducing long-term costs to the system, and improving educational and life...
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PFD report
53match
Michael Cooper
Chronic underfunding of mental health services led to a critical lack of inpatient beds and excessive Care Coordinator caseloads, causing delayed follow-ups and inadequate risk assessments.
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PFD report
53match
Bradley Morgan
Mental health services suffered communication breakdowns and severe underfunding, resulting in excessive staff caseloads and a lack of timely patient follow-up, which created a risk to life.
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PFD report
53match
Michael Wheeler
Inadequate mental health service funding led to a lack of psychiatrist review for a patient with severe paranoia and inpatient bed shortages, overstretching Home Treatment Teams.
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PFD report
53match
Maeve Boothby O’Neill
There is a critical lack of specialist healthcare provision and funding for research into severe Myalgic Encephalomyelitis (ME). Limited doctor training and inadequate NICE guideline details on managing severe ME are also significant concerns.
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Committee recommendation
52match
#5 - Pensioners face increased health risks and unsustainable care demand without a preventative, whole-system approach
As pensioners are generally on a fixed income, they face challenges responding to cost-of-living increases. Those on low incomes are likely to respond by cutting back on food, energy use and social interactions, adding to existing health risks. Various social and environmental risk factors such as poverty, bereavement and isolation and cold as well as lifestyle factors such...
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terms: prevention
Committee recommendation
52match
#23 - NHSE's top-down guidance significantly hinders local health systems' intended resource allocation autonomy.
Local areas would value more flexibility about where they can direct their resources to achieve greatest impact, including how they fund measures to prevent ill health. ICBs were supposed to have greater autonomy in determining how to allocate resources locally compared to their predecessor bodies, including freedom to shape future local health services. However, there is widespread agreement...
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terms: prevention
PFD report
49match
Philip Dean
Mental health services were underfunded and under-resourced, leading to fragmented care, inadequate recording of critical information, and delayed professional assessments for severely unwell patients.
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PFD report
49match
Kate Dolby
Chronic underfunding and staff shortages in mental health services, particularly for doctors in the EIP team, led to precarious patient care and significant delays in treatment.
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PFD report
49match
Stephen Jackson
Mental health services failed to provide essential post-discharge follow-up from the home treatment team despite an urgent GP referral, leaving the patient unsupported due to underfunding.
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PFD report
49match
William Edge
A suicidal patient was discharged without adequate follow-up from the Home Treatment Team, who could not revisit despite an urgent family request, due to critical bed shortages and underfunding.
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Committee recommendation
49match
#14 - Ninth report - Clearing the backlog caused by the pandemic
As part of its national health and care recovery plan, we recommend that the Government sets out the contribution that public health services will make, and ensures that this contribution is backed with a level of funding that acknowledges their crucial role.
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Committee recommendation
49match
#11 - Prioritise funding and support for local preventative services to reduce acute service demand.
The Ministry must prioritise funding and support for local preventative services to fix the foundations, reduce the demand for acute services, and bring down costs in the longer term. (Recommendation, Paragraph 50)
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Committee recommendation
49match
#10 - Temporary central government funding is required to rebuild damaged preventative services.
Rebuilding and strengthening damaged preventative services will require temporary increases in central government funding before the demand for acute services starts to drop. (Conclusion, Paragraph 49)
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Committee recommendation
49match
#13 - Government obstructs FGM reconstructive surgery by failing to fund necessary research.
Many women who have undergone FGM seek reconstructive surgery to reverse FGM as far as possible. It is clear that the NHS is equipped to perform this surgery as it delivers it for other medical conditions. We acknowledge that the current medical evidence supporting reconstructive surgery for FGM survivors may be limited. However, it is unreasonable for the...
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Committee recommendation
49match
#32 - Increase government support for grassroots initiatives enabling Muslim women's participation in social activity.
The Government should increase its support for community-led grassroots initiatives aimed at supporting Muslim women and girls to participate in social activity. (Recommendation, Paragraph 118) 54
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HMICFRS recommendation
48match
PEEL 2018-19 CoC Recommendations: Cleveland Police
Cause of concern: The force doesn’t appropriately prioritise crime prevention. There is a lack of strategic direction, and the force doesn’t allocate enough resources to prevention work. Staff who carry out prevention work lack an understanding of the priorities they should be tackling. Recommendation: The force should take immediate steps to:• monitor the effectiveness of its crime prevention...
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terms: prevention
HMICFRS recommendation
48match
PEEL 2021-22 CoC Recommendations: Cleveland Police
Cause of concern: The force hasn’t fully addressed the cause of concern about preventing crime and antisocial behaviour identified in the 2019 PEEL inspection.#10265 "The force doesn’t appropriately prioritise crime prevention. There is a lack of strategic direction, and the force doesn’t allocate enough resources to prevention work. Staff who carry out prevention work lack an understanding of...
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terms: prevention
Committee recommendation
47match
#39 - 4th Report - Game On: Community and school sport
Sport and physical activity remain underrecognised within national health policy, despite strong evidence of their value for prevention, wellbeing and the management of longterm conditions, and despite the Government’s stated support. While England is regarded as a leader in social prescribing, provision remains inconsistent and lacks an overarching strategy. Gyms, leisure centres and community groups already play a...
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terms: prevention
PFD report
45match
Mohan Acharya
Emergency department crowding is a significant risk factor associated with increased mortality among admitted patients, contributing to approximately 500 deaths annually.
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Committee recommendation
45match
#6 - Ensure greater NHSE funding for community services, preventing redirection to hospitals.
NHSE’s long-held ambition to move more care from hospitals to the community has stalled. There would have been more investment and progress in mental health and community services, particularly GP surgeries and dental services, in 2023–24 had NHSE not redirected funding to prop up the day-to-day spending of local NHS systems. Despite carrying out 15% more elective activity...
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Committee recommendation
45match
#14 - Fund urgent research into FGM reconstructive surgery effectiveness, with NHS provision if proven beneficial.
The Government should facilitate and fund research into the effectiveness of reconstructive surgery for FGM survivors as a matter of priority. If evidence indicates that the surgery is effective, then the NHS should provide it. (Recommendation, Paragraph 44) Estimating the prevalence of FGM
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Committee recommendation
45match
#73 - Refocus High Needs Block funding towards early intervention and identification in mainstream settings.
The High Needs Block should be refocused to enable and incentivise earlier intervention. Currently, a significant proportion of this funding is directed towards supporting high-cost, specialist provision once needs have escalated. While such provision is vital for some, a more preventative approach is needed to reduce long-term need and improve outcomes. Redirecting a greater share of High Needs...
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Committee recommendation
44match
#19 - Restore dedicated ring-fenced funding for maternity care Service Development Fund to £95 million.
We strongly recommend that the Government restore the dedicated ring- fenced funding for the Service Development Fund for maternity care to £95 million. Properly targeted we believe this investment has the potential to reduce the substantial cost of maternity negligence claims to the NHS and more than pay for itself. (Recommendation, Paragraph 91)
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Inquiry recommendation
41match
MAI-98 - Extend first aid education in National Curriculum
The Department for Education should consider extending the National Curriculum to ensure that pupils, once of an appropriate age, receive education in all first responder interventions.
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Committee recommendation
40match
#13 - Ninth report - Clearing the backlog caused by the pandemic
The pandemic has had a negative impact on health inequalities and highlighted the crucial importance of effective public health services in supporting local populations. Public health services are therefore vital allies in tackling the backlog, and we are surprised at the decision merely to maintain current public health grant funding levels.
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Committee recommendation
40match
#24 - Diagnostics require further investment and greater integration across the entire health system.
Lord O’Neill told us that although DHSC and its arm’s-length bodies have done a decent job in some key areas, they have not really progressed diagnostics. He is of the view that diagnostics should be embedded across the entire health system, which would improve productivity as well as addressing AMR.62 Dr Partridge told us that while there was...
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Committee recommendation
40match
#1 - 4th Report - Game On: Community and school sport
The evidence shows that funding community sport and physical activity is an investment with high returns, including savings on healthcare costs, productivity gains, and wider wellbeing benefits. The consequences of under‑investment are costly. Ageing infrastructure, higher operating costs, and reduced access lead to facility closures, lost participation, and increased pressure on health and social care budgets. While the...
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Committee recommendation
40match
#1 - Second Report - Local authority financial sustainability and the section 114 regime
The failure to properly fund children’s and adult social care, especially adult social care, is the single biggest threat facing local government financial resilience. Given that the cost of providing social care consumes between 60% and 70% of the budgets of top-tier councils, a solution to this funding crisis alone could largely restore local government finances. The Government’s...
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Committee recommendation
40match
#24 - Investment in research for drivers of substance misuse behaviours remains inadequate
Dame Carol and Ms Wiseman told us that there was little investment in research into the behaviours and factors that lead to substance misuse.80 The JCDU pointed to the £5 million investment in the ‘innovation fund’ which is looking at building evidence around the key area of reducing demand.81 However, departments have committed just £350,000 to research drivers...
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Committee recommendation
40match
#2 - Revise draft RSHE guidance on menstrual health due to insufficient and late teaching
However, we are concerned that the teaching of the menstrual health element of relationships, sex and health education is insufficient and inconsistent. It is often delivered too late in a child’s development to be of use and by teachers who lack the necessary training. The requirement in the draft guidance that schools need to cover reproductive health conditions...
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Committee recommendation
40match
#6 - Government lacks consistent cross-departmental strategy for older people, conflicting with preventative health goals
The Government says it is taking a cross-department approach to address the challenges faced by older people. We were interested in arguments that it would help to have a strategy where the Government set out its objectives for older people and the mechanisms to ensure that those priorities are reflected in policy across government departments. As an example,...
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Committee recommendation
40match
#66 - Declining adult education funding threatens efforts to upskill workforce and achieve social goals
Funding for adult education and skills has declined sharply since the early 2000s, particularly in classroom-based learning. The Government’s reduction in adult education funding for 2025–26 will further undermine efforts to upskill the existing workforce and to support those who are out of work or struggling to progress. Reduced investment in adult education threatens the Government’s broader social...
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Committee recommendation
39match
#18 - Reduced Maternity Service Development Fund risks widening disparities and compromising critical reforms.
We are concerned by the Government’s decision to cut the Maternity Service Development Fund from £95 million to £2 million. While ICBs still have access to this funding, maternity services must now compete with other local priorities. While performance metrics in the 2025–26 NHS Assessment Framework aim to ensure accountability, they do not guarantee sufficient funding will be...
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Committee recommendation
36match
#26 - 4th Report - Game On: Community and school sport
We recommend that the Government make physical education a core subject within the national curriculum. (Recommendation, Paragraph 76)
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Committee recommendation
36match
#2 - 4th Report - Game On: Community and school sport
We recognise the pressures on the public finances. Investing in sport, however, by creating a more active population, will eventually lead to significant savings, particularly in the health and welfare budgets. We recommend that the Government increase the 0.3% (£3.8 billion) share of total government expenditure on sport and recreation to at least 0.6% (£7.6 billion at current...
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Committee recommendation
36match
#3 - Ensure RSHE teachers receive training and deliver comprehensive reproductive health education early
The Government should ensure teachers tasked with delivering the menstrual and gynaecological health element of RSHE receive the training necessary to deliver it effectively. Information on women’s reproductive health conditions should be taught early on in secondary education, preferably around the time most girls first experience menstruation. That information should include guidance on what is and is not...
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Committee recommendation
35match
#40 - DHSC's neglect of long-term NHS sustainability led to a record maintenance backlog.
This committee has highlighted many times in the years since 2016 that DHSC has focused on short-term survival of NHS services, while neglecting long-term sustainability, 78 Qq 49–51 79 Q 94 80 Q 91; C&AG’s Report, para 4.2 81 C&AG’s Report, paras 3.17 and 3.19 82 Q 109 83 Q 109; C&AG’s Report, para 18 84 Qq 109,...
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Committee recommendation
31match
#25 - 4th Report - Game On: Community and school sport
We recommend that the Government require schools to have a policy to give every child the opportunity to achieve at least 60 minutes of physical activity a day. We further recommend that the Government set clear expectations for activity to be woven into the school day, through short movement breaks, active travel, and wrap‑around provision. (Recommendation, Paragraph 75)
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Committee recommendation
31match
#9 - 4th Report - Game On: Community and school sport
We were concerned about reports that the Department for Health and Social Care (DHSC) had sought to renege on commitments to provide funding for physical education. Given the importance of PE and sport to improving health outcomes, and the potential in the longer‑term for consequential savings to the NHS, we expect DHSC to put its share of funding...
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